Kristin Eisele
Kennett Square,PA
Summary
Precertification professional with comprehensive experience in healthcare administration and insurance verification. Known for strong interpersonal skills, team collaboration, and adaptability to changing needs. Reliable, results-driven, and focused on achieving organizational goals.
Hardworking team player offering staff support. Responsible, punctual and productive professional when working with little to no supervision.
Overview
25
25
years of professional experience
Work History
Precertification Specialist
Genesis HealthCare
101 E State St Kennett Square, PA 19348
02.2017 - Current
- Coordinated precertification processes for patient admissions, ensuring compliance with healthcare regulations.
- Reviewed medical documentation to verify eligibility for services, enhancing accuracy of approvals.
- Collaborated with healthcare providers to gather necessary information for timely precertifications.
- Mentored junior specialists in complex cases, promoting skill development and knowledge sharing.
- Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
- Enhanced interdepartmental collaboration through effective communication with case managers, physicians, and billing departments.
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Ensured smooth communication between healthcare providers, patients, and insurance companies, resulting in timely approvals and positive experiences.
- Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
- Nurtured strong professional relationships with insurance representatives, fostering a collaborative atmosphere during negotiations on behalf of patients.
- Minimized claim denials by accurately coding procedures according to CPT guidelines before submission for approval.
- Increased accuracy of submitted claims through meticulous attention to detail in verifying insurance eligibility and benefits.
- Processed and certified documents for accuracy and compliance with government regulations.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Performed various administrative tasks by filing, copying and faxing documents.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
Medical Receptionist
Nemours Children's Health System
1068 W. Baltimore Pike, Suite 4403 Media, PA 19063
06.2001 - 02.2017
- Coordinated communication between patients, families, and medical staff to ensure seamless operations.
- Maintained electronic health records with high accuracy to support patient care initiatives.
- Trained new staff on office procedures and software systems to boost team effectiveness.
- Managed patient scheduling and appointment confirmations to enhance clinic efficiency.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Managed high call volumes, directing calls to appropriate departments while maintaining a polite and professional demeanor.
- Managed multi-line phone system and pleasantly greeted patients.
- Provided compassionate customer service, creating a welcoming atmosphere for patients and their families.
- Maintained current and accurate medical records for patients.
- Enhanced patient satisfaction by efficiently managing the front desk operations and addressing inquiries in a timely manner.
- Developed strong relationships with patients, fostering loyalty and trust in the practice''s services.
- Assisted healthcare providers with administrative tasks, enabling them to focus on quality patient care.
- Contributed to a positive work environment by collaborating effectively with colleagues and supporting team initiatives.
- Ensured accurate record-keeping by diligently updating patient information and verifying insurance coverage.
- Transcribed phone messages and relayed to appropriate personnel.
- Kept waiting room neat and organized by stacking magazines, removing trash, and cleaning glass.
- Streamlined appointment scheduling for improved patient flow and reduced wait times.
- Coordinated specialist referrals for patients requiring additional care, facilitating efficient transfer of medical records as needed.
- Supported office staff and operational requirements with administrative tasks.
- Handled billing procedures accurately, ensuring prompt payment from both patients and insurance providers.
- Organized essential medical documents, streamlining access to vital information for healthcare providers during appointments.
- Reduced no-shows by implementing appointment reminder system through phone calls or text messages.
- Facilitated effective communication between patients, medical staff, and insurance companies to ensure seamless coordination of care.
- Enhanced patient understanding by providing clear explanations of treatment procedures.
- Optimized appointment scheduling to maximize doctor availability.
- Facilitated smooth check-in process, ensuring all necessary paperwork was completed promptly.
- Streamlined office communication by effectively coordinating between doctors and nurses.
- Increased patient satisfaction by answering inquiries with empathy and professionalism.
- Fostered welcoming environment, greeting patients warmly upon arrival.
- Supported patient care by scheduling appointments to accommodate urgent health needs.
- Improved patient follow-up, reducing missed appointments through effective reminder calls.
- Facilitated patient education by distributing relevant health and wellness pamphlets.
- Reduced administrative errors by consistently verifying insurance information.
- Obtained payments from patients and scanned identification and insurance cards.
- Assisted with medical coding and billing tasks.
- Received and routed laboratory results to correct clinical staff members.
- Managed office bookkeeping with insurance billing and patient payments.
- Performed various administrative tasks by filing, copying and faxing documents.
Education
Associate of Science -
Associate of Arts - Liberal Arts
Delaware County Community College
Media, PASkills
- Prior authorization
- Strong communication skills
- HIPAA compliance awareness
- Organizational growth
- Professionalism and ethics
- Medical billing
- Medical coding
- Data entry
- Documentation and reporting
- Telephone etiquette
- Recordkeeping and data input
- Teamwork
- Problem-solving
- Time management
- Attention to detail
- Multitasking
- Reliability
- Adaptability and flexibility
- Insurance authorizations
- Self motivation
- Medical terminology
- Documentation review
- Professionalism
Timeline
Precertification Specialist
Genesis HealthCare
02.2017 - Current
Medical Receptionist
Nemours Children's Health System
06.2001 - 02.2017
Associate of Science -
Associate of Arts - Liberal Arts
Delaware County Community College